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General NPI Number Information
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NPI Number | 1689792038
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Entity Type | Organization
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Legal Business Name | FEHR ORTHODONTICS, LTD
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3800 ARCHER DR SUITE 200
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City | EAST MOLINE
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State | IL
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Zip | 61244-3757
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Country | US
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Telephone | 309-751-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 ARCHER DR SUITE 200
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City | EAST MOLINE
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State | IL
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Zip | 61244-3757
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Country | US
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Telephone | 309-751-3080
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DALE EDWARD FEHR
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Credential | DDS,MS
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Telephone | 309-751-3080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | IL
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